'Roz And Ray' Is A Gripping Story Of Tough Choices On The Edge Of Biomedicine

Usually when I see plays at the local theatre, I fall asleep. But Roz and Ray, the biomedical drama playing its premiere in Seattle, kept me on the edge of my chair.

This is a story based on a painful chapter in biomedical history--the AIDS epidemic in the 1980s. It’s driven by two characters. Roz is the doctor trying to do her best to serve her young hemophilia patients. Ray is the father of two boys counting on her to keep them alive and active.

Things get ethically dicey as two forces emerge in parallel–a new blood-clotting therapy that appears at first to be a godsend for hemophiliacs, followed by the realization that the AIDS virus has created a new, and deadly, contamination risk to the blood supplies used to make the drug. Scientists and physicians struggle at first to understand the problem, the scope of it, and to figure out what to do. Until experiments are run that could help provide a clear road map, the doctor and the patients’ father are stuck. They don’t have a lot of good information to go on. This makes for compelling tension between the two main characters.

Let me say here that I’m a biotech journalist, not a theatre critic. I write about science, often at the moment it comes into contact with business, and moves from the realm of ideas into the world of real-world application. Quite a lot of uncertainty and risk goes with the territory. Things change fast. A so-called breakthrough one day may be found to have a surprising side effect the next. Often, decisions have to be made based on information that isn’t exactly black and white.

Playwright Karen Hartman, an artist-in-residence at the University of Washington, brilliantly captures the confusion, and the moral ambiguity, about life on the edge of biomedicine. Through her deft use of flashbacks in a back-and-forth interrupted narrative, instead of a straightforward chronology, the theatergoer gets a strong sense for the emotional highs and lows of the characters. One minute, they are close–sometimes too close–while making life and death decisions for children. The next thing you know, Ray, the father of the hemophiliac boys, is leading an angry protest, accusing the doctor of having a financial conflict of interest in the biomedical-industrial complex, and of having blood on her hands.

The truth, as is often the case, is somewhere in between.

Hartman says she was inspired to pursue this subject based partly on personal experience. Her father was a hematologist during the 1980s AIDS crisis. He didn’t talk much at home about the experience. Hartman began researching the subject years after he died.

“It started as an investigation of something that haunted my father, and by osmosis or empathy or obsession haunted me as well,” Hartman said. “But these characters are primal to me--Roz, a good doctor faced with impossible choices and also a need for closeness that cuts against her professional boundaries, and Ray, a ferociously grieving father who needs a place to channel his sorrow and rage. I am most interested in political subjects that are morally freighted, rather than areas where I feel morally clear.”

This moral ambiguity is what makes the show so powerful. While many people look to science for facts and data, life on the biomedical forefront is naturally chaotic, conflicting and confusing. Moral dilemmas come with the territory, at least until new ideas stand up to the test of time and independent scientific scrutiny.

“The play reminds us that the incredible scientific progress of the last 30 years has not always followed a straight line, but an unpredictable, sometimes treacherous path impeded by gaps in our knowledge of what’s possible,” said Braden Abraham, the artistic director of the Seattle Repertory Theater, the playhouse that produced the show.

While scientists search for the answers, life goes on for doctors and patients. They often have to make wrenching personal decisions about their health on the thinnest reeds of information. People may yearn for outward projections of confidence, bravery and clarity. But it would be wise for everyone involved--doctors, patients, drugmakers, society--to recognize the ambiguity, and to operate with a little more humility and empathy toward others who are often trying their best, but sometimes falling short. Not everything can be reduced to good vs. evil. “To me this is a story of interdependence in a fiercely individualistic society,” Hartman says.

The play isn’t perfect. A romantic interlude seemed jarring. Drugmakers come across as evil, faceless corporations. One minute, they’ve provided a magical treatment that greatly improved the lives of hemophilia patients. The next, they’re accused of genocide, cavalierly allowing deadly blood contamination into their products as they pursue their profits. The financial arrangements, and motives, of the hospital and drugmakers could be fleshed out just a bit more, without distracting from the personal dilemma of the two main characters.

These are small beefs for a play that packs powerful emotional punch. At a time of so much promise in biomedical research labs, Roz and Ray is a show that many people should see. We need a way to look at and talk about the nuance, the ups and downs, the twists and turns of biotechnology. Roz and Ray is not only entertaining, but it can force us to confront an important, and poorly understood, part of our world.

Luke Timmerman is a journalist, author, and entrepreneur. He is the founder of Timmerman Report, a biotech newsletter. Luke is also the author of "Hood: Trailblazer of the Genomics Age," a biography of Leroy Hood. Luke has won a number of prizes for his reporting, including ...